What is Kwon's method (Devolution epicanthoplasty=Magic epicanthoplasty)?

Magic epicanthoplasty(Kwon’s method) is a unique method for correcting epicanthal folds of Asian eyelid, and is the surgery to be first founded by Dr. Kwon. Kwon’s method is based on the devolutional concept that restores original pericanthal structure for stable double eyelid formation without anatomical distortion. It can be accomplished by just rearranging the soft tissue without risk of severe complication or noticeable scar. Unlike conventional methods, Magic epicanthoplasty primarily releases the malpositioned soft tissues and fibrosis, then leads to the restoration of the medial canthus naturally without the removal of the skin or muscle.

Magic epicanthoplasty(Kwon’s method) is a universal method for various Asian epicanthus, and is the basal surgery for double eyelidplasty for Asian. 

The clinical significance of epicanthal fold is mainly related with double eyelidplasty in Asians.
Epicanthal fold is worsened when performing double eyelidplasty without epicanthoplastyas double eyelid aggravates tension on epicanthal skin. And aesthetic results of double eyelidplasty without epicanthoplasty tend to be unnatural or unattractive.When performing out-fold type eyelidplasty without epicanthoplasty, prolonged swelling retention(so-called sausage phenomenon) occurs due to blockage of lymphatic flow by vertical tension and fading away of double eyelids are frequently noted.Unless the epicanthoplasty releases skin tension and remove potential inhibition factors of crease loss, the surgical crease will not look natural or not be able to last in any enduring fashion.

In the early days of epicanthoplasty surgery, numerous surgical methods were introduced to correct the redundant skin fold which were based on the concept of local flaps.
However, their disadvantages such as difficulty in design and resultant prominent scars had limited their use. Recently new epicanthoplasty methods have been introduced to correct Asian anatomical differences such as excessive skin, abnormal skin tension, a malpositioned orbicularis muscle, fibroadipose tissue, elongated medial canthal ligament, etc. However, none of them could be a treatment of choice as they lacked exact understanding regarding the malposition of upper orbicularis muscle and vertical skin tension in relation to the double eyelid. The surgical methods based on defective/inadequate understanding of the true nature of the epicanthus could not be sufficiently effectivefor Asian eyelidplasty.

Epicanthoplasty using devolutional method(Kwon's method) was developed on the basis of our understanding of epicanthal formation and causal relationship with double eyelid. Therefore, it is a completely new technique first made by Dr. Bongsik Kwon. This method is also called the magic epicanthoplasty. With good reports and reputations by people who have already undertaken this, it is becoming a term that is commonly used in Korea and in many other countries.

To perform magic epicanthoplasty, a surgeon needs plentiful experiences and extreme carefulness to acomplish optimal results. Teuim plastic surgical clinic have more than 5000 cases of magic epicanthoplasty alone or combined double eyelid surgeries. 

Example) Magic epicanthoplasty in Asian single eyelid

Example)Magic epicanthoplasty in Asian with double eyelid 

Example)Combination of the Magic epicanthoplasty with the non-incisional double eyelid surgery

Example)Combination of the Magic epicanthoplasty with the incisional double eyelid surgery

 

Example)Combination of the Magic epicanthoplasty with the ptosis correction surgery

Example)Combination of the Magic epicanthoplasty with revisional double eyelid surgery 

<Teuim Clinic Dr.Kwon>

What is non-incisional ptosis correction?

VividEye surgery - Functional and structural non-incisional double eyelid surgery with ptosis correction ? This new ptosis correction procedure was introduced in 2010, and just like its name, is performed without using any incisions.

Teuim Plastic Surgery Clinic has developed its own method to supplement double-eyelid surgery with the non-incisional ptosis correction procedure VividEye, which has been especially tuned for Korean or other similar ethnic groups to deliver the most aesthetically pleasing results.

VividEye, non-incisional double eyelid surgery with ptosis correction, bases its procedure with special consideration for the eye-opening power, eye shape and size unique to Korean or other ethnic groups similar to Korean individuals for the following reasons:

1. Caucasion individuals have a natural double eyelid feature because part of their levator muscle is connected to a piece of skin underneath the upper eyelid. Korean people, however, have several characteristics that prevent the formation of a double eyelid crease; the orbicularis muscle behind the upper eyelid skin is too thick, the orbital fat sags too low, or mostly importantly, there is too much tension in their Mongolian folds.

2. The orbicularis muscle surrounding the eye serves an important function of allowing individuals to close their eyelids. Korean people have more prominently developed orbicularis muscles, and have particularly thick fibrous bands in the inner corners of their eyes, creating the Mongolian folds. These folds make it difficult for eyes to open completely and also prevents the formation of double eyelid creases. Furthermore, while double eyelid creases lie along a horizontal vector of the eye, they are counteracted by the tension created by Mongolian folds, causing surgically created double eyelid creases to unravel. Korean people cannot be subject to the same methods of double eyelid surgery used on the caucasian people.

In other words, because the majority of Japanese people and south asian people are considered as Southern Mongoloids with weak tension in their orbicularis muscles, Korean people, catergorized as Northern Mongoloid, cannot be subject to the same surgical methods, because they would experience inconsistent results. Taking into consideration the structural differences between Korean (Asians) and other races, the Teium Plastic Surgery Clinic has modified the surgical method and created VividEye to ensure the best possible results for those undergoing the eye procedure.

Who is eligible for VividEye?

1.Those who are eligible for non-incisional double eyelid surgery, but also suffer from mild ptosis. In the past, all ptosis corrections have required the use of incisions, but VividEye provides both non-incisional double eyelid formation and non-incisional ptosis corrections.

2.Those who have natural double eye lids but drowsy looking eyes.

3.Those who have already undergone double eyelid surgery but wish to increase the vertical size of their eyes

4.Those who want minimal recovery time and a quick return to their normal routines avoiding incision method (The orbital fat was removed via stab incision)

5.Males who wish to increase the vertical size or exposure of their eyes without having heavily defined double eyelid creases.

6.Those who are unsatisfied with a previous incisional ptosis correction.

7.Those who do not want procedural scars, want bigger eyes, minimal or small double eyelids

8.Patient suffered from a severe degree of ptosis. A Magic epicanthoplasty with VividEye can correct these cases.

9.For making paralell (out-fold type) double eyelid, vivid eye surgery is helpful in some cases.

Things you should know

1.In order to avoid complications or unnecessary procedures, we recommend you to first come in and consult with us or send us photos if you are considering or indicated to VividEye 

2.Avoid touching or rubbing your eyes for three to four weeks due to the chance of loosening buried stitches. 

3.Those who have undergone vision or laser eye corrective surgery should wait for about three months before electing to have VividEye.

Frequently Asked Questions

 

Am I eligible for VividEye if I suffer from a severe case of ptosis?

=>Severe cases of ptosis can be due to congenital reasons or levator dehiscence and can lead to unsatisfactory results from VividEye. This could be different the case of Muller type ptosis, no matter how severe. In any event, we

Is it as simple as non-incisional double eyelid surgery?

=>VividEye is similar, but requires more surgery time as it is a bit more involved. Recovery time however, is similar to conventional non-incisional double eyelid surgery. 

Will VividEye allow me to choose the height of the double eyelid crease?

=>Yes, you can choose where you wish to have your double eyelid crease to be located. 

How much recovery time will I need after VividEye?

=>When undergoing incisional ptosis correction, it takes about two weeks for major surgical swelling to subside. However, you should expect to recover from major swelling in just a week after VividEye. 

Do I need to worry about my double eyelid crease unraveling or becoming loose after surgery?

=>Even incisional double eyelid surgery with ptosis corrections carry some risk of becoming loose or unraveled after surgery, and VividEye has a similar potential. However, corrective or revisional surgeries in those cases are much easier and simpler for VividEye. 

I am a male who is not interested in having the double eyelid crease, and do not want it to be obvious that I have had surgery. What can VividEye do for me?

=>One of the great advantages of VividEye is that it does not have strict requirements for males. Although VividEye cannot avoid the double eyelid crease completely, it can be minimized to be barely visible. 

I have had incisional double eyelid surgery with ptosis correction in the past, but I am unsatisfied with the results. Instead of revisional surgery, should I just elect for VividEye?

=>In the absence of any major scarring or adhesions, we recommend that you come in for a consultation so that we can see what VividEye can do for you. 

Teuim  Aesthetic plastic surgical clinic - Dr.Kwon

http://english.teuimps.co.kr

Modern meaning of a double eyelid

According to a survey from the human resource team of major companies, people preferred an egg-shaped face with big eyes in both of women and men. According to research, it is said that people who have an attractive face are known to be considered as better workers. Plastic surgery is now not an extravagance, it is actually another way of self-development.

Classification of the double eyelid - In folder& Out folder 

What is in folder, in-out folder, and out folder?

In-folder eyelid 

An in-fold is a shape of a natural double eyelid, which is most general for Koreans in respect of the anatomical structure around the eyes. The eyelid line is started by a slight coverage of the Mongolian fold and looks very thin and natural. If the Mongolian fold is severe, the epicanthoplasty may be needed.

 Examples) Performing only double eyelid surgery on these kinds of eyes renders them have in-folder type eyelids

 Examples) Slight improving of an inner corner opening by Magic epicanthoplasty in severe in-folder type eyelids.

 Examples) Improving of inner corner double eyelid line by Magic epicanthoplasty in severe in-folder type eyelids.

Examples) Structural double eyelid surgery combined with the Magic epicanthoplasty and double eyelid surgery for parallel type of double eyelid.

Out-folder (parallel type)

An out-folder is an eyelid line that starts from the heads of eyes without touching the inner corner. Westerns mainly have this structure and they have an eye socket structure that’s depressed inside more than their forehead and nose.

In Asians, it can be made only by undertaking proper epicanthoplasty. But it can look unnatural even after proper combined operations because of the structural differences of eyes. When only the double eyelid operation is performed, swelling will be severe and may last for a long time. This will lead to unnatural eyes.

Examples) High and unnatural double eyelid line without the improvement of Mongolian folds

Examples) An out-folder line in an Asian eyes with Mogolian fold looks them unnatural. Magic epicanthiplasty was performed to correct them.

  

Examples) Structural double eyelid surgery combined with the Magic epicanthoplasty and double eyelid surgery for parallel type of double eyelid.

Examples) Combination of Magic epicanthoplasty and reisional double eyelid surgery.

Examples) Combination of Magic epicanthoplasty and reisional double eyelid surgery.

Examples) double eyelid surgery without epicanthoplasty. The proper degree of an out-folder line that can be permitted to Asians in case of minimal epicanthal tension.

In-out-folder

An in-out-folder is the middle form of an in-folder and an out-folder. The line starts from the tip of the corner of the eye and is extended beautifully to the end of the eye. It is a very clear and natural look for the Asian eyes and is a line that is preferable by everyone. This line does not look unnatural and only looks splendid and attractive. In most cases, it can be formed only when Magic epicanthoplasty is done together.

 Examples) Combination of Magic epicanthoplasty and non-incisional double eyelid surgery to make an in-out-folder line.

Examples) Magic epicanthoplasty can change an in-folder to an in-out-folder line.


 Teuim  Aesthetic plastic surgical clinic - Dr.Kwon

The double eyelid

What is double eyelid surgery?

Although the eyelid is very thin, various tissues (skin, muscle, fat, eyelahes, the conjunctiva) are composed in it. The elevator muscles are the ones that help open the eyes and it is usually attached to the eyelid board. The parts of the muscle tissues are attached to the back of the skin of the eyelid and the skin attached is raised, then a double eyelid is made.
For most Westerners, parts of the elevator muscle of the upper eyelid are attached to the back skin, While for Asians, it is not and the natural double eyelid is rare. Typical Asian eyes have no double eyelid, but a small height with strong tension of Mongolian folds. So this makes the eyes look stuffy compared with the eyes of the Westerner’s eyes.
There are three general methods, the complete incision method (incision), partly cutting (partial incision), and cutting for only the needle to enter(buried suture method). From any among them, we must connect a part of the elevator muscle of the upper eyelid to the eyelid. There are merits and demerits respectively and it should be determined by enough consultation through considering the length and size of the eyes, thickness of the skin, power to open eyes, quantity of fat, Mongolian folds and so on. Recently, the complex operation, Magic epicanthoplasty combined with double eyelid surgery, dramatically improves the Mongolian folds and connects the eyelid with the levator muscle of the upper eyelid. This must be the fundamental step for plastic surgery of the eyes. If considering the correlation between the Mongolian fold and the double eyelid, it can make effective and dramatic results. 

Examples) Structural double eyelid surgery combined with the Magic epicanthoplasty and double eyelid surgery

Anatomical elements when forming a double eyelid

The principles when forming a double eyelid is determined by whether the muscle pulling up eyelid is raised by holding skin at the same time. For Westerners, the muscle raising the eyelid holds the skin and the skin is raised as they open their eyes and forms a double eyelid.

While for Asians, most have no connection between the muscle and the skin and also, the thick fat and the muscle raising the skin is blocked. Therefore, a double eyelid operation creates not only this connection, but also eliminates the Mongolian fold, muscle, or the fat of eyes and finally creates beautiful eyes. 

Structural factors for a beautiful eyelid are needed when :

>The width of the eyes is long and the tails of the eyes are not so pointed upwards.

>The distance between the eyes and eyebrow is not to be short.

>The skin of the eyelid is tense and not hung down.

>The eyelid skin is thin

>Proper amount of fat exists but not too much.

>There’s no severe existence of the Mongolian fold.

>The function of the muscle to open the eyes is normal and the exposure of pupil is good.

>Both eyes are symmetric

>The position of the eyebrow is not hung down and is symmetric.

* In cases where a lot of these conditions are satisfied, the operation can give you very good results without any difficulties. But actually, most of cases are not like that. If you don’t meet any or only a few of these conditions, there may be a chance that undesirable results may be shown.

Functional meaning of a double eyelid in respect of having a field of vision

A single eyelid of Asians is likely to cover a pupil and when it is severe, eyelashes can prickle the pupil and it can cause visual obstructions. And because of this, patients take the forehead lifting actions, but this in fact causes wrinkled forehead to appear. In this case, a double eyelid incision removing parts of an eyelid and forming a double eyelid and extending exposure or pupil, will brighten the patients’ vision.
Therefore, a double eyelid has an important effect to create a better vision as the basic function of the eyes. After the operation the eyes are expressed as more clear and bright.

Examples) An excisional double eyelid surgery has an important effect on providing a better vision (exposure of pupil)

 Examples) Cases showing depressed type of dark circle treated by dual plane fat graft.

 Examples) Forming an inner type of double eyelid and increased exposure of pupil by ptosis correction and a double eyelid surgery. After surgery, the position of eyebrow previously lifted has been brought down significantly.

Examples) Forming an parallel type of double eyelid and increased exposure of pupil by ptosis correction and double eyelid surgery.

Teuims complex enlargement surgery.

If your eyes are small, or if you are a person who wants to extend and enlarge your eyes, a complex operation with the Magic epicanthoplasty, lateral canthoplasty, eye enlargement and an extension of the height of your eyes can help your eyes dramatically.

Examples) Magic epicanthoplasty combined with an excisional double eyelid surgery and lateral canthoplasty

Examples) Magic epicanthoplasty combined with an excisional double eyelid surgery and lateral canthoplasty

 Teuim  Aesthetic plastic surgical clinic - Dr.Kwon

 http://english.teuimps.co.kr

 

Dr.kwon's Epicanthoplasty (teuim clinic)

Dr.kwon's Epicanthoplasty (teuim clinic)

Magic epicanthoplasty converting negative opinions from         conventional methods

It can be surely said that when the problem of Mongolian folds are properly solved, the expression of the eyes changes into clear and beautiful looking eyes in many aesthetic aspects.

"I usually hear that I glare at people too much." "My eyes look stuffy even after taking the double eyelid surgery" "People say my eyes look gathered in, but an eye specialist says "I'm not a squint." "I have small eyes but want them to be wider and bigger."

These are probably the main complaints from the people who have severe 'Mongolian folds'. However, many women always have hesitated to take epicanthoplasty because of some supposedly “negative reputations” and permanent scars. When a scar is deep, it cannot be concealed even on top of make-up.

This also can be a serious concern. Also, almost conventional methods of epicanthoplasty have carried prejudice and negative reputations until now. If beautiful double eyelids were achieved with a very minimal scar, no one would hesitate.

Through high satisfaction and reliance by people who already underwent this surgery, the Magic epicanthoplasty has changed recognition of epicanthoplasty positively.

We believe that the Magic epicanthoplasty operated in Teuim plastic surgery can help people who want to have a wide and beautiful expression of eyes.

Examples) scarless magic epicanthoplasty

Magic epicanthoplasty as a new paradigm in double eyelid surgery

It is generally said among plastic surgeons that there is no more difficult surgery than the double eyelid operations. The most difficult problem for a plastic surgeon has been that every eye could not be expressed beautiful under various conditions by only the conventional or pre-existing methods.

Many studies about the Mongolian fold and its solution have not been properly suggested, and the results of the surgeries were mostly determined by confined conditions of eyes themselves. No more than 4-5 years ago, many hospitals did not perform epicanthoplasty and the reason for this was that there was no ideal method to eliminate Mongolian folds aesthetically.

The Mongolian fold is a characteristic of the Northeast Mongoliod races which makes the distance of between eyes looks longer than its actual distance and forms small, stuffy or unfavorable eyes. Good candidates of eyelid surgery are determined by the degree of the Mongolian folds.

An important key is that taking surgery on the eyes without properly managing the Mongolian folds causes unfavorable lines or can be a critical reason for getting your double eyelids to fade away. In fact, most of the problems after double eyelid surgery are caused by the tension of the remaining Mongolian folds.

Considering all things, Mongolian folds have been an important key, but it had not been operated properly because of its scar or undesirable results. Most women say "I want to have beautiful and clear eyes", or "I want to have bigger eyes after surgery" during surgery consultations.

However, a person who has severe Mongolian folds, small eyes and a wide interepicanthal distance, taking only double eyelid surgery itself, can result in a devastating appearance and also a strange feeling by the skin remaining and covering over the epicanthal region. In case of non severe Mongolian folds, the double eyelid surgery alone can possibly make relatively desirable and favorable lines, but only an in-folder type of double eyelid line will appear after all.

If one has severe Mongolian folds, it should be considered that epicanthoplasty creates a clearer and well-defined double eyelid line by exposing the hidden part of the eye when it is performed with double eyelid surgery at the same time.

Now, through the foundation of the Magic epicanthoplasty, it is becoming unnecessary to hesitate when considering an epicanthoplasty, Recently, with the universal utility of epicanthoplasty and Magic epicanthoplasty plus double eyelid operations, these two combined methods tend to be the firm basic concept for the plastic surgery of the eyes.
Considering the relationship of a Mongolian fold and a double eyelid, these combined surgeries can generate a perfect plan and create dramatic results.

Examples) Magic epicanthoplasty combined with a double eyelid surgery in a patient having severe Mongolian folds

Examples) Magic epicanthoplasty combined with a revisional double eyelid surgery in a patient having severe Mongolian folds. 

Would it be right to only take the Magic epicanthoplasty, or should I have to take it with the double eyelid surgery?

Although Magic epicanthoplasty and double eyelid surgery require different procedures and are both different surgeries but, undertaking both can give you great results. You must be noted that the heads of your eyes have Mongolian folds so the eyelid forming a double eyelid is a continuous unit of skin.

Magic epicanthoplasty can be also performed either to the innate double eyelid or to the surgically made double eyelid. In this case, partial correction of the line near the epicanthal angle(corner) can be required to expose the double eyelid more clearly

. Magic epicanthoplasty is also possible to be performed on a single eyelid, and if needed, the double eyelid operation can be done later. However, in most cases of a single eyelid, these two combined surgeries are recommended.

Magic epicanthoplasty is a definite method that can make the effective lengthening of eyes in a horizontal plane. Considering the relationship between Mongolian folds and double eye lids, these two combined procedures can be a better choice to express dramatic results.

Examples) A case showing awkward double eyelid lines when only undertaken an out-folder type double eyelid surgery without epicanthoplasty previously.
Magic epicanthoplasty combined with partial correction of inner double eyelid line can create high completion of continuous line at the inner corner region. 

 Examples) Magic epicanthoplasty combined with non-incisional double eyelid surgery resulting in parallel line.

 Examples) A case showing asymmetric and faded double eyelid lines when only undertaken an in-folder type double eyelid surgery without epicanthoplasty previously.
Magic epicanthoplasty combined with revisional double eyelid surgery can create high completion of continuous line at the inner corner region.

Examples) Magic epicanthoplastycombined with a revisional double eyelid surgery in a patient having severe Mongolian folds. 

Is Magic epicanthoplasty different from the conventional operations in terms of its effects?

Currently existing other surgeries are operated by various methods such as simple excision (Hiraga's method) and the z-plasty. However, they all belong to the same category in that the surgeons eliminate a partial skin of the Mogolian fold and suture each side. As a result, a scar after surgery may remain and there was limitation in surgical effect. When the Mongolian fold is severe, the surgical line also becomes larger, and a scar can be easily detected.

Magic epicanthoplasty(Kwon's method), through the careful study of the Mongolian fold, is a new concept of surgery that releases the tension and leads the soft tissue to be redistributed spontaneously by itself without further surgical manipulations. In the respect of the effects and reuslts, it can extend the width up to 3mm each eye (if one has severe degree of Mongolian folds,) and can also lengthen the inner corner of your eyes with exposing your double eyelid line.

A great advantage of Magic epicanthoplasty is that the scar is not remained on the region sutured. Besides, this operation is not a method of excision. It is rather accomplished by rearranging the soft tissue without a surgical excision, so there is no worry to feel drawn back and tensed around the remaining scar. That is, of course, a scar is necessarily made by a suture tension but, the problem of a scar was solved through considering the tension of skin asmuch as possible. 

What are the differences between Magic epicanthoplasty and existing surgeries in detail?

	Pre-existing epicanthoplasties	Magic epicanthoplasty
Effective of extending the width of eyes	small	Large. Possible to fix
Change of expression of eyes	Gives a fierce impression to eyes	Gives a natural impression to eyes
Scar on the inner corner of eyes	Remains	Does NOT remain
Effective for the poke of eyelashes	No	Improved
Effective for lovebands (skin under eyes)	No	Sometimes
Effective for a more distinct double eyelid line	No	Yes
Effective for fine wrinkles under eyes	No	Yes
Effective for dark circle	No	Yes
Management after surgery	Needed	Not needed
Ease the tension of Mongolian folds	No	Yes

Characteristics of the Magic epicanthoplasty

In Magic epicanthoplasty, surgical region is not visible and it is hidden, so a scar is hardly seen after removal of the stitches. The scars are not visible after 5 days of the removal of stitches

With a new concept that’s different from the existing methods, it is unnecessary to worry about a scar. In conventional methods, a scar lasts longer and the permanent scar will be unavoidable. However, Magic epicanthoplasty, is not a method by excision and suturing the skin, but a method incision and rearranging the soft tissue and skin by itself which can create natural looking eyes

After the Magic epicanthoplasty, it is unnecessary to worry about your eyes becoming sharper or pointing downward. In Teuim plastic surgery, we perform it by making the corner of your eyes direct in a comfortable horizontal angle, with the consideration of the overall inclination of eyes.

Extreme carefulness and operational skills are needed to operate the surgery. We must prudently consider the proper skin tension condition of a patient at surgery. We do not perform the same operation to all patients. We must consider the shapes of the double eyelid line or expression of eyes a person wants to obtain. The correlation between the nose and eyes, direction and severity of Mongolian folds are applied for the most proper method to the individual's eyes to make best result as the mostsuitable way for the patient. That is why the surgery takes roughly an hour.

http://english.teuimps.co.kr/ 

Teuim  Aesthetic plastic surgical clinic dr.kwon